I have received the following opinion piece from a source who doesn’t want to be identified but has an interesting perspective on this important issue. The author works in the University community and presents a wonderful level on introspection on the current issue with the Friends of Science initiative to write to the University Vice Chancellors attacking natural therapies and to intimidate the government appointed Reviewers within NH&MRC about funding research in Complementary Medicines which they do very little of anyway.

Now the Gillard government, under the guise of reducing costs, has indicated in pre-budget ‘leaks’ that various practices such as Naturopathy are to be investigated for their evidence when it comes to tax benefits related to private health insurance. In other words we intend to disadvantage those people who look after their own health and in so doing may choose therapies other than those administered by medical doctors or other registered practitioners. Some years ago one of the health insurance companies was able to demonstrate to the then Health Minister Tony Abbott that those people who availed themselves of the ‘alternate’ treatments offered in private health policies, were actually costing the government less per year.

Also under attack by the government is the Complementary Medicine industry with the recent release of the levels of evidence guidelines from the TGA, even in the words of one of our industry’s main critics Ken Harvey fromLatrobeUniversity, the proposed guidelines “would probably result in 90% of (Complementary Medicine) products disappearing from the market”. Australians already have less access to Complementary Medicines than other countries. How quickly we forget that the Federal Government has now paid out more than $120 million of taxpayer’s money in out of court settlements attributable to the Pan saga to companies in the Natural Products Industry in a veiled attempt to cover up what the court clearly believed was wrongdoing after minutes of meetings were ordered to be destroyed by departmental officers. One could be forgiven in thinking that the Government has a demonstrable bias against Complementary Medicines.

Is there need for regulatory reform? Yes there is. And are some product claims unwarranted? Yes they are, but as in the Pan saga the government needs a tack hammer not a sledge hammer to protect the public. There are good and competent people that work within the TGA and I am hopeful that with the new leadership there will be some positive outcomes under the regulatory reform process which will benefit all Australians. Remember it is the inalienable right of all Australians to choose their therapy and their medicines be they drugs or nutritional medicines. We all need to work collectively to achieve better health outcomes no matter what are belief systems are.

THE ROLE OF ELECTED GOVERNMENT IS TO PROTECT PEOPLE’S RIGHTS NOT TO PREVENT THEM.

Regards,

Marcus Blackmore

Universities told only to teach “correct” knowledge.

A group of what seem to be primarily medical academics calling themselves the “Friends of Science in Medicine” recently wrote to all Vice Chancellors concerning Alternative and Complementary Medicine or health degrees.

It’s pretty clear to see that essentially they want University medical and health education to be owned only by traditional western medicine departments (perhaps that they run or work in) and other approaches to be relegated to sub degree level. Not a bad strategy, because then its virtually impossible for alternatives to get funding for research, and in time the alternative approaches can be said to have no evidence!

They say they are not against Alternative Medicine, but the thinly veiled impression is that they want to ensure it is not taught at Universities apart from by themselves, from a western perspective as placebo effects.

I’m not pro or against either form of medicine, but I have spent 30 years listening to consumers, including Doctors and health professionals, and doing rather substantial amounts of large scale research, and it seems to me that this FSM is somewhere trapped in the past and really disconnected from the reality of the knowledge economy.

The real threat is that they are saying that one group of prominent people has the right to tell Universities, and through them the public, what can and cannot be taught, and that “they” control “correct” knowledge.

Can you imagine the reaction if Psychologists said sociology and anthropology should not be taught? Or one branch of physics said quantum physics should not be taught. Or climate skeptics said pro climate change courses should not be taught. Maybe they will be telling Universities not to teach Islamic studies or theology because these are primitive ways of seeing things and don’t have satisfactory evidence. It’s one thing to debate ideas; quite another to use power groups to restrict higher education and knowledge, and send us back to the inquisition where “ True Knowledge” is controlled by a minority.

In the Internet version of their letter they say:

“we are trying to discourage universities from running pseudo-scientific courses which undermine the scientific credibility of those universities and we hope to influence government and others responsible for funding such courses.”

They appear to be attacking the base of the freedom of Universities to pursue knowledge and diversity in disciplines of knowledge. It’s like going back to a time when people were burnt at the stake for their hypotheses, or had to hide because intellectuals of any persuasion apart from the totalitarian one, were hunted and imprisoned. Every academic in every discipline should fear the potential impact of a group such as this. It’s much bigger than Western versus alternative medicine.

Lets consider why. They want evidence to be at the base of teaching. Nothing wrong with that. But on four levels their argument fails.

First the funding of research into Complementary and Alternative Medicine (CAM) is substantially lower than all the government grants and pharmaceutical funding globally over decades to Western medical faculties. Its quite early days since controlled trials were established in the CAM fields and whilst FSM seems to say there is nothing proved, many writers claim they are ignoring anything other than that which supports western Medicine or Placebos.

By removing CAM degrees the chance of developing a strong evidence base by CAM research, which is starting to get off the ground, will disappear, apart from that run in Western medicine disciplines under their paradigms.

Second is the “throwing stones in greenhouses” effect. This group ignores the fact that much Western medical research has many evidence-based problems. Even a cursory read on the web convinces one that the academic medical worlds research is sometimes very questionable. Search subjects like: “problems with medical research”; “fraud in medical research;” “can you trust the medical journal research?” “Can you trust evidence based research in medicine?” Three Million deaths in the US due to prescription medicines is enough to say “get your own house in order”.

Problems with Medical research include removal of data or cases in medical research, and a huge range of issues from data, sample, method, controls through to choice even of subject. Some articles even suggest that a large number of medical research controlled trials are questionable.

They have been using restricted repertoires of research methods for so long now that they think their restricted scientific paradigm is the only paradigm that can be used. Go to other disciplines and there are a wide variety of ways of producing evidence. Western medicine is a pseudo science also, compared to pure sciences such as physics and engineering where the majority of variables can be included, observed over a definable period, and controlled?

It is locked into one research paradigm; a pseudo-science one that ignores numerous variables as it tries to simplify life and living into sets of measureable elements, with often little understanding of the range of other factors that may impact life. It is a pity, because Western Medicine has achieved huge breakthroughs in many areas; but it has also had little impact overall on many of the so-called modern day diseases where it has stuck to its singular pseudo science paradigm for evidence.

As such this group has a great chance of damaging further the reputation of scientists in general in the eyes of consumers, at a time when we hear many young people are not inclined towards science.

Third, when we listen to consumers they talk about Pharmaceutical companies who removed data on the side effects of some drugs; they talk about their own choices in treatment; they are suspicious of the links between academic researchers and commerce. They prefer however properly trained and graduated Western and CAM professionals, they respect their GP’s, Nurses and CAM professionals. They want choice and they want all of these to have the benefits of University education, rather than to just “fall into it”.

When we listen to the academic medical fraternity, its easy to see that the closed shop works like this. A Doctoral candidate chooses a subject, which will fit with the supervisor’s interests. They start their work from the body of knowledge (within the square); they research, often controlling certain variables, they publish and get their PhD and the eminent supervisor gets their name on the publications.

This adds to the academic supervisors citations. As the citations build they get higher up in the medical academic system. Then they are invited onto grant awarding panels. And of course we now have the “square” locked in mind judging who should be funded and who should not be funded.

So knowledge is developed within a set of minds that have to perform within a narrow tunnel of what is considered to be evidence-based knowledge.

Fourth these academic silos are a long way from the day-to-day work of the dedicated front line GPs, Nurses or others who interact with consumers and see the variability of treatment and conditions and lifestyles. For the FSM, controlled randomized trials (which are often no more than pseudo science) are the reality. For everyone else, the human in society, with the variability that indicates, is also the reality. The communiqué from academic research comes only if you pay to read the journal articles (which you don’t have time for), or you hear through the pharmaceutical reps.

Connection with reality would help these academic medics to realize that in many of their pieces of research so many variables are omitted to do with life and living, that many of the claimed and publicized results are laughable. It does not help us to know that in a tiny sample of people there was minor differences in a certain prognosis on say liver damage in those who snore versus those who don’t (just because the statistical method shows that !)

However, it’s very clear that Western medical research has by lucky chance sometimes, sequences of research at others, and the many incredibly talented scientists, made massive breakthroughs. Many academic medics have done this. That is something they should be proud of. But theirs is just one paradigm of research-pseudo scientific controlled randomized samples. There are many other paradigms of research, used across countless disciplines, and it is gross arrogance to try to prevent these being taught and utilized.

Reading blogs following this group, its interesting that they grab on to the most extreme examples of CAM, or things from way back in the past…and ignore the thorough health, science and biological training that takes place in CAM courses. One hopes they are a little better in how they approach evidence in Western medicine, but this does not give great confidence !

And overall, FSM and similar groups just are so out of touch with the general consumer. Consumers are choosing many forms of alternative medicine, complementary medicine, vitamins and minerals, nutritional advice and ways to try to improve their health. The gradual erosion of trust in academic medical research and the way that it is now servant of commercial needs, academic careers , journal articles, and similar rather than the servant of the consumer, the GP and the nurse, is widely understood.

This type of arrogance makes the consumer think that all these people are doing is trying to protect their turf by removing other choices for the consumer. This little world of academic medics who have been schooled through the same institutions, lived at the same colleges, joined the same elites, purchased the same brands of cars and suburbs, and gradually seen their “brand” lose face among consumers are now running scared. Lets see how fast they run once they whip up enough opposition to make serious statisticians and others start to pull apart and publicise their research paradigms and methods. They are picking of one at a time- homeopathy, then chiropractors , then who next. So the opposition will easily pick off different disciplines and show how their so called academic medical research has huge failings.

This “war” started by FSM is the last thing that we need in an overstretched health system, and one hopes that young medical academics and practitioners will say enough is enough-we have to learn from many approaches to health and medicine. Its time for the old men dominated academic medical profession to have a significant change so we can have a better future.

So what do we need to do?

First every academic in every discipline should be talking to their Vice Chancellors about this fundamental attack on the freedom of Universities to decide what they consider to be knowledge and research.

Second, if some of the signatories of the FSM letter are on grant making committees, it appears they are not supportive of research into CAM apart from in medical faculties as placebos or similar.

In fact the internet version of the email that was sent to potential signatories seems to have targeted people who advise on the award of grants- an interesting issue of the independence of such advisers to the Government. It says:

“We are writing to you, as you have been trusted by the NH&MRC to review applications to the council for support. Obviously you will only support good science and may well be as frustrated as we are that “pseudoscience” is flourishing.

They then ask their support for the petition which seems to be against CAM courses in Universities.

They should be required immediately to state conflict of interest and remove themselves from any grant making or similar committees that hear proposals for CAM research in Non medical faculties. Further to this, all political parties should institute an enquiry into whether health and medical research is silo-ed or fully represents the spread of opportunity for both preventing ill health and treating ill health. The consumer is demanding with their feet a better deal.

Third, to get real evidence based medicine, the Government should require that on any grant making committee there are equal numbers of expert representatives from Western Medicine and CAM, and that there are also non-medical statisticians and non medical research methodology experts to ensure that both fields have to come up to non medical statistical standards and also are open to a range of research paradigms for creating evidence, not just the overriding pseudo scientific paradigm used in much western medicine research.

Fourth, Western medicine has to get to grips with why so many consumers turn to CAM. I suspect this is the fear driving this old style thinking. A preservation of the old ways. This sort of strategy is going to alienate more people again. When I read of FSM, as someone right out of this field, I could not believe that this type of arrogance still existed.

Fifth, those who signed the FSM letter. Did they really understand what they are doing in restricting knowledge? I cannot believe that among them there are not lots of very dedicated sincere people. They can’t all be this narrow minded and blind to what is going on in society? Perhaps many of them will want to consider whether they signed up for what they think they signed up for. FSM seems to indicate it is not against CAM, just does not want it to be seen as legitimate by allowing Universities to train people properly in it. That seems to be incongruous.

FSM is part of a campaign orchestrated from overseas. Read about it on the Internet. I think the ordinary consumer would feel that some strategy worked out somewhere in the UK or USA to attack CAM practitioners and exported here, is not acceptable. It is an attack on the choice of the consumer, the GP’s who are open to many forms of prevention and treatment, and the CAM specialists.

Sixth, every consumer out of the huge percentage who use a combination of western and CAM Medicine, should phone or email their MP and the Vice Chancellor of any local Universities, and request that the rights of CAM academics and practitioners are supported, and that no one has the right to stop people being properly trained in both. And the 40% (or less?) of us who don’t use CAM, but still believe in the great benefit of freedom of knowledge and education, should do the same as this sets a very dangerous precedent.

More important than any of this, is that those intelligent, dedicated and open minded people in academia and practice from both western and CAM approaches should be working together to find the best combination of techniques to promote health and treat illness and to share their education and research. FSM seems to be asking for the exact opposite of such collaboration, an outdated notion of society and the knowledge economy.

GP’s, Nurses and CAM’s are working together, so why can’t you? That’s what a large percent of consumers expect for what they pay in tax for your salaries, careers, departments, conferences, benefits and fame through citations.

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The author is a businessperson who has conducted very substantial amount of research, trained many researchers, and regularly is amused by the lack of variables, the claims, and the restriction in research paradigms, included in some medical research. He believes medical research should be much better quality and evidence based in a broader sense than for instance commercial research on doughnuts or bumper bars.

2 responses to “A new perspective”

Pretty nice post. I just stumbled upon your weblog and wished to say that I’ve truly enjoyed surfing around your blog posts. In any case I’ll be subscribing to your rss feed and I hope you write again very soon!

I think the anonymous article was excellent. However I think it underestimated the lack of evidence behind Western Medicine. According to the British Medical Journal’s Clinical Evidence group only 11% of common medical interventions are supported by strong evidence such as a randomised controlled clinical trial (RCT). I have estimated the figure for cancer is closer to 7%.

I asked Professor John Dwyer from FOSM to provide details of one such RCT that suppports the benefits of surgery for cancer in terms of increased survival. He was not able to do so. So the whole cancer industry is based on an invalid, unproven assumption of what cancer is.